Knowledge and skills required to perform point-of-care ultrasonography in family practice – a modified Delphi study among family physicians in Slovenia

Abstract

Background: More and more family physicians (FPs) are using point-of-care ultrasonography (POCUS) in Europe. Still, there is no general consensus about the specific knowledge and skills that a FP should acquire in order to effectively perform POCUS. The objective of this study was to identify indications for the use of POCUS among FPs, explore the barriers of its use and provide an expert opinion of FPs on knowledge and skills required to effectively implement POCUS in family practice. Methods: A modified two-round Delphi study was carried out among FPs using POCUS in Slovenia. Results: 21 FPs were invited to participate in the study. A total of 13 FPs (62%) responded the round-one questionnaire and 10 (48%) completed the round-two questionnaire. Results show a large variability of indications for the use of POCUS in family practice, the most common being acute abdominal conditions, lung ultrasonography and eyeballing echocardiography. In contrast, the results show little variability in barriers for the use of POCUS, the most common being lack of time, inaccessibility of specific training programmes and financial issues. There is a strong consensus on the knowledge and skills needed to perform POCUS. Panellists agreed on a learning medical knowledge, technical skills and expressed a need for individual consultations and tutorship options. Conclusion: This study proves that although POCUS is used in family practice for a wide variety of indications with a significant number of barriers, there is a strong consensus on what a FP needs to know to effectively perform POCUS.

Sonografie in der Hausarztpraxis

“…Beginnend mit der digitalen Übertragung der Patientendaten aus der Praxissoftware in das Sonografiegerät bis hin zur digitalen Bildspeicherung in die Patientenakte kann eine annähernd unterbrechungsfreie und zeitsparende Arzt-Patienten-Konsultation gewährleistet werden. Tatsächlich ist dies ein entscheidendes Kriterium im häufig überlaufenen und zeitlich eng begrenzten Praxisalltag [1]. Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen.…”

Protocol for a Delphi Consensus Study to Determine the Essential and Optional Ultrasound Skills for Medical Practitioners Working in District Hospitals in South Africa

“…The Scandinavian curriculum focuses largely on soft tissue ultrasound applications, which, though included, are not a focal point in the Slovenian curriculum. The Slovenian curriculum, in turn, regards the identification of renal stones with ultrasound as a core competency, while the Scandinavian curriculum does not [ 21 , 22 , 23 ]. If these differences exist among developed countries, they are likely to be even more pronounced among developing countries, and between the developing and developed world [ 23 , 24 ].…”

Point-of-care ultrasound education needs for nurse practitioners in primary care settings: An integrative review

“…Thirteen of the articles were quantitative studies, of which 11 were observational studies (Boniface et al, 2019;Bornemann, 2017;Dornhofer et al, 2020;Hall et al, 2021;Lindgaard & Riisgaard, 2017;Safavi et al, 2018;Snelling et al, 2021;Wong et al, 2013;Yamada et al, 2018), one was a mixed case-control and expert-opinion Delphi study (Homar et al, 2020), and one was a case-control study (Tuvali et al, 2020).…”

“…The JBI quality scores for the observational cohort studies ranged from 3 to 10 on an 11-point scale (Boniface et al, 2019;Bornemann, 2017;Dornhofer et al, 2020;Hall et al, 2021;Lindgaard & Riisgaard, 2017;Safavi et al, 2018;Snelling et al, 2021;Wong et al, 2013;Yamada et al, 2018); however, three of the scores were not measured on the 11-point scale, as some point categories were not applicable (Bornemann, 2017;Safavi et al, 2018;Wong et al, 2013). The JBI scores for the text, narrative, and opinion articles ranged from 4 to 6 on a 6-point scale (Barron et al, 2019;Chamsi-Pasha et al, 2017;, and from 3 to 6 on a 10-point scale for the two case control studies (Homar et al, 2020;Truvali et al, 2020); however, not all points were relevant on the 10-point case control scale, as some eligible points were not relevant to the research question. The AGREE II scores ranged from 32 to 55 on an 87-point scale for all four practice guidelines (AAFP, 2018; ACEP, 2016; Lewis et al, 2018;SPOCUS, 2018).…”

“…Participants were recruited through variations of convenience sampling (Boniface et al, 2019;Bornemann, 2017;Dornhofer et al, 2020;Hall et al, 2021;Homar et al, 2020;Lindgaard & Riisgaard, 2017;Safavi et al, 2018;Snelling et al, 2021;Truvali et al, 2020;Wong et al, 2013;Yamada et al, 2018), and no studies had consecutive enrollment. The populations studied included physicians with some practice patterns related to primary care (Homar et al, 2020;Lindgaard & Riisgaard, 2017;Wong et al, 2013); medical students (Safavi et al, 2018;; assistant and medical clinical officers with practice patterns similar to physicians and NPs ; nurses and midwives (Dornhofer et al, 2020;Hall et al, 2021); or some combination of the aforementioned populations (Boniface et al, 2019;Bornemann, 2017;Dornhofer et al, 2020;Hall et al, 2021;Truvali et al, 2020;Yamada et al, 2018). There was only one study that included NPs, which was conducted by Snelling et al (2021).…”